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Abstract #0058

Preventing visual field deficits from neurosurgery using intraoperative MRI

Gavin P Winston 1 , Pankaj Daga 2 , Mark J White 3,4 , Caroline Micallef 3,4 , Anna Miserocchi 5 , Laura Mancini 3,4 , Marc Modat 2 , Jason Stretton 1 , Meneka K Sidhu 1 , Mark R Symms 1 , David J Lythgoe 6 , John Thornton 3,4 , Tarek A Yousry 3,4 , Sebastien Ourselin 2 , John S Duncan 1 , and Andrew W McEvoy 5

1 Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, England, United Kingdom, 2 UCL Centre for Medical Image Computing, London, United Kingdom, 3 Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom, 4 Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom, 5 Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom, 6 Centre for Neuroimaging Sciences, Institute of Psychiatry, Kings College London, England, United Kingdom

Anterior temporal lobe resection (ATLR) for refractory epilepsy may cause a visual field deficit (VFD) that precludes driving. We studied 21 patients undergoing ATLR in an intraoperative MRI (iMRI) suite. Preoperative tractography of optic radiation was displayed on the navigation and operating microscope displays either without (9 patients) or with (12 patients) correction for brain shift. Display of the optic radiation during surgery significantly reduced the degree of VFD and no patient developed a VFD that precluded driving (compared to 13% of a historical non-iMRI cohort). Outcome did not differ between iMRI guidance with and without brain shift correction.

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